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母亲孕期体重增加与后代肥胖和体重指数 Z 分数风险的关联,超过平均值。

Associations of maternal gestational weight gain with the risk of offspring obesity and body mass index Z scores beyond the mean.

机构信息

Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia.

Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia.

出版信息

Ann Epidemiol. 2019 Apr;32:64-71.e2. doi: 10.1016/j.annepidem.2019.01.007. Epub 2019 Jan 25.

Abstract

PURPOSE

We examined the association of meeting the 2009 Institute of Medicine gestational weight gain (GWG) guidelines with offspring obesity and body mass index Z score (BMIZ) at age six overall and by maternal weight status.

METHODS

Data were from the Infant Feeding Practices Survey II Study (2005-2007) and their Year Six Follow-Up Study (2012). Logistic regression and quantile regression models were used.

RESULTS

Eleven percent of children were obese. Children born to mothers who gained excessive weight during pregnancy had an increased risk of obesity as compared with those born to mothers who gained adequate weight (adjusted odds ratio: 1.67). The association was stronger among normal-weight mothers (adjusted odds ratio: 3.50). Inadequate GWG was not associated with offspring obesity overall or in subsamples by maternal prepregnancy BMI. Children born to mothers who gained excessive weight had higher BMIZ. This distributional association was more pronounced among normal-weight mothers. Children born to obese mothers who gained inadequate weight had lower BMIZ at some percentiles of the BMIZ distribution.

CONCLUSIONS

Excessive GWG was associated with increased risk of offspring obesity and higher BMIZ at age six, whereas inadequate GWG was protective of high BMIZ among children born to obese mothers.

摘要

目的

我们研究了是否符合 2009 年美国医学研究所(Institute of Medicine)的妊娠增重(GWG)指南与后代肥胖和 6 岁时体重指数 Z 分数(BMIZ)之间的关系,以及该关系是否因产妇体重状况而异。

方法

数据来自婴儿喂养实践调查 II 研究(2005-2007 年)及其 6 岁随访研究(2012 年)。使用逻辑回归和分位数回归模型进行分析。

结果

11%的儿童肥胖。与体重增加适当的母亲所生的孩子相比,体重增加过多的母亲所生的孩子肥胖风险增加(调整后的优势比:1.67)。对于正常体重的母亲,这种关联更强(调整后的优势比:3.50)。总体而言,GWG 不足与后代肥胖无关,也与母亲孕前 BMI 的亚组无关。体重增加过多的母亲所生的孩子 BMIZ 较高。这种分布关联在正常体重的母亲中更为明显。体重增加不足的肥胖母亲所生的孩子,在 BMIZ 分布的某些百分位上,BMIZ 较低。

结论

GWG 过多与后代肥胖风险增加和 6 岁时 BMIZ 较高相关,而 GWG 不足对肥胖母亲所生的儿童高 BMIZ 具有保护作用。

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